Statins Update – News and Views

November 17, 2010

Statins are regarded as a lifesaver by some and a dangerous medication by others. I have written on this before and just by coincidence this week three separate news stories turned up on different aspects of these drugs.

Their primary use is to lower blood cholesterol levels by blocking the action of a chemical in the liver that is necessary for making cholesterol. So far so good, and they are used to maintain normal cholesterol levels and so lower the risk of chest pain (angina), heart attack, and stroke.
Unfortunately, in my view, they are over prescribed and used to simply alleviate anxiety about possible future health conditions and instead of promoting healthier lifestyle choices through diet and exercise. Here is the news – and you make up your own mind.

Statins 1: The Good News
Study results presented at the Ninth Annual AACR Frontiers in Cancer Prevention Research Conference, held Nov. 7-10 in Philadelphia have indicated that long-term statin use is unlikely to increase cancer risk for bladder, breast, colorectal, lung, pancreatic, prostate, or renal cell cancer, but was associated with lower risk of melanoma, endometrial cancer and non-Hodgkin lymphoma.

This was a decent-sized study that included 133,255 participants in the Cancer Prevention Study II Nutrition Cohort and they completed several questionnaires and were followed over a period of about 10 years. During that time more than 15,000 participants were diagnosed with cancer.

Statins 2: The Not So Good News
According to a study in the British Medical Journal statins significantly increase a person’s risk of cataracts, muscle weakness, liver dysfunction and kidney failure. Unlike the previous report, they also confirmed that the drugs lower the risk of heart disease and oesophageal cancer, but claims of other health benefits were unsupported.

Again this study is a respectable size, as researchers from Nottingham University examined data on more than 2 million patients between the ages of 30 and 84, seen at 38 different general practices, who had been prescribed statins.

The researchers confirmed prior data suggesting that statins increase patients’ risk of cataracts, liver dysfunction, kidney failure and a form of muscle weakness known as myopathy. They found that for every 10,000 women treated with the drugs, 23 would develop acute kidney (renal) failure, 39 would develop myopathy, 74 would develop liver dysfunction and 309 would develop cataracts. Men suffered an even higher risk of myopathy, but their risks of the other three conditions were similar to those suffered by women.

In a nutshell, the researchers found that only 434 people would need to be treated with the drugs for five years for one case of acute renal failure to develop. It would take only 136 treated for each case of liver dysfunction and 33 for each case of cataracts. Among women, 259 would need to be treated for each case of myopathy; among men, the number was only 91.

The risk of developing all conditions was highest during the first year of treatment, but continued throughout the course of the study. Risk of liver and kidney problems increased proportionally with the dose of statins being taken.

Further research involving statins and cancer has come from the large population-based Women’s Health Initiative (WHI) in the US. Their findings are that statins fail to reduce colorectal cancer in postmenopausal women.

Michael S. Simon, M.D., professor of oncology in the department of oncology at Wayne State University and Barbara Ann Karmanos Cancer Institute, Detroit presented these study results at the previously mentioned Ninth Annual AACR Frontiers in Cancer Prevention Research Conference and according to him, the results from several case-control studies have shown a moderate reduction in colorectal cancer risk in people who use statins. However, a majority of the literature researching the association, including data from randomized controlled trials and cohort studies, show no association between statin use and reduced colorectal cancer risk.

Statins 3: Better News
The Nottingham researchers did find, however, that the risk of cataracts returned to normal within one year of stopping statin treatment, while the risk of liver and kidney problems returned to normal within one to three years. Additionally, they found no connection between statin use and the risk of dementia, osteoporotic fracture, Parkinson’s disease, rheumatoid arthritis or venous thromboembolism.

Unlike stated in Statins 1, these researchers found almost no data supporting claims they reduced cancer risk. The study “largely confirmed other studies that reported no clear association between statins and risk of cancers,” according to the researchers. The only cancer-fighting effect uncovered in the study was a slightly lower risk of oesophageal cancer, with eight cases averted for every 10,000 high-risk women treated. In other words, 1,266 high-risk women or 1,082 high-risk men would need to be treated with the drugs to prevent one case of oesophageal cancer.

It is a lot to take in, and you are going to have to assess your own risk of potential heart disease and high cholesterol against the other health risks associated with these drugs. As ever, adopting a healthier lifestyle is an essential first step to dealing with high cholesterol before resorting to any drug regime.